Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.37 / $7.08 / $10.96	Facility	26	$5.37	$7.08	$10.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $93.33	Professional		$27.54	$39.81	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $23.44	Professional	26	$6.03	$8.91	$23.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.75 / $38.90 / $58.88	Professional	50	$11.75	$38.90	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $57.54	Professional	TC	$20.89	$28.18	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $48.98	Professional		$28.18	$38.90	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.13 / $14.13	Professional	26	$6.46	$8.13	$14.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.84 / $44.67	Professional	TC	$20.42	$28.84	$44.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $30.90 / $39.81	Professional		$6.46	$30.90	$39.81
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $70.79	Professional		$34.67	$46.77	$70.79
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $24.55 / $24.55	Professional	26	$7.76	$24.55	$24.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $77.62	Professional		$28.18	$40.74	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.23 / $19.50	Professional	26	$6.92	$10.23	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $61.66	Professional	TC	$20.42	$29.51	$61.66
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $338.84	Professional		$263.03	$338.84	$338.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $83.18	Professional	26	$67.61	$67.61	$83.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $269.15 / $269.15	Professional	TC	$208.93	$269.15	$269.15
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $7.08 / $10.96	Facility	26	$5.13	$7.08	$10.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $44.67 / $95.50	Professional		$28.84	$44.67	$95.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.00 / $21.38	Professional	26	$6.03	$10.00	$21.38
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $38.90 / $58.88	Professional	50	$38.90	$38.90	$58.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $67.61	Professional	TC	$20.89	$32.36	$67.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $32.36 / $33.11	Professional		$6.76	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $38.90 / $83.18	Professional		$8.71	$38.90	$83.18
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $89.13	Professional		$27.54	$40.74	$89.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.33 / $17.78	Professional	26	$6.92	$9.33	$17.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $52.48	Professional	TC	$19.95	$28.84	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $36.31 / $58.88	Professional		$29.51	$36.31	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.51 / $14.79	Professional	26	$7.41	$8.51	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $27.54 / $43.65	Professional	TC	$21.38	$27.54	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $50.12	Professional		$39.81	$41.69	$50.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.51 / $10.23	Professional	26	$8.13	$8.51	$10.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.88 / $39.81	Professional	TC	$32.36	$33.88	$39.81